Addressing health literacy in patient decision aids
Addressing health literacy in patient decision aids
Methods
We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews.
Results
Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which health literacy needs were addressed.
Conclusion
Lower health literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower health literacy users. The specific effects of PtDAs designed to mitigate the influence of low health literacy are unknown. More attention to the needs of patients with lower health literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher health literacy patients.
1-14
McCaffery, K.
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Holmes-Rovner, M.
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Smith, S.
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Rovner, D.
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Nutbeam, Don
352dc808-9160-42e7-8b52-b8cac02ad486
Clayman, M.L.
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Kelly-Blake, K.
e93b6d49-f0ac-485a-95dc-fbe231228105
Wolf, M.
f2b7e8d7-10a7-4817-b9bd-52486d908440
Stacey, S.
0f507056-ada6-4d7c-ba3f-e769f2d2911f
29 November 2013
McCaffery, K.
db7b9561-97f2-41cb-bbc0-01e7099676a6
Holmes-Rovner, M.
70a00d2d-60f0-4116-8a39-e4a1038afaff
Smith, S.
8904521d-3b46-4112-8566-e08de3e011a5
Rovner, D.
d6cbd965-593f-463d-b63a-8b52180f3531
Nutbeam, Don
352dc808-9160-42e7-8b52-b8cac02ad486
Clayman, M.L.
11ace6ce-1813-4029-b639-770ae2d35d41
Kelly-Blake, K.
e93b6d49-f0ac-485a-95dc-fbe231228105
Wolf, M.
f2b7e8d7-10a7-4817-b9bd-52486d908440
Stacey, S.
0f507056-ada6-4d7c-ba3f-e769f2d2911f
McCaffery, K., Holmes-Rovner, M., Smith, S., Rovner, D., Nutbeam, Don, Clayman, M.L., Kelly-Blake, K., Wolf, M. and Stacey, S.
(2013)
Addressing health literacy in patient decision aids.
BMC Medical Informatics and Decision Making, 13, supplement 2, .
(doi:10.1186/1472-6947-13-S2-S10).
(PMID:24624970)
Abstract
Methods
We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews.
Results
Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which health literacy needs were addressed.
Conclusion
Lower health literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower health literacy users. The specific effects of PtDAs designed to mitigate the influence of low health literacy are unknown. More attention to the needs of patients with lower health literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher health literacy patients.
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1472-6947-13-S2-S10.pdf
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Published date: 29 November 2013
Organisations:
Faculty of Social, Human and Mathematical Sciences
Identifiers
Local EPrints ID: 359790
URI: http://eprints.soton.ac.uk/id/eprint/359790
PURE UUID: 4920fdae-82b4-4400-95d2-5c96ab0f979b
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Date deposited: 13 Nov 2013 14:41
Last modified: 14 Mar 2024 15:29
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Contributors
Author:
K. McCaffery
Author:
M. Holmes-Rovner
Author:
S. Smith
Author:
D. Rovner
Author:
Don Nutbeam
Author:
M.L. Clayman
Author:
K. Kelly-Blake
Author:
M. Wolf
Author:
S. Stacey
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